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Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk

Background and objectives. The efficacy of commonly prescribed analgesic and adjuvant drugs for the management of patients with radiculopathy has not been well established. Oral steroids are commonly used to treat sciatica or radiculopathy due to a herniated disk but the effect remains controversial...

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Autores principales: Oros, Mykhaylo, Oros Jar, Mykhailo, Grabar, Vasyl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915681/
https://www.ncbi.nlm.nih.gov/pubmed/31739434
http://dx.doi.org/10.3390/medicina55110736
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author Oros, Mykhaylo
Oros Jar, Mykhailo
Grabar, Vasyl
author_facet Oros, Mykhaylo
Oros Jar, Mykhailo
Grabar, Vasyl
author_sort Oros, Mykhaylo
collection PubMed
description Background and objectives. The efficacy of commonly prescribed analgesic and adjuvant drugs for the management of patients with radiculopathy has not been well established. Oral steroids are commonly used to treat sciatica or radiculopathy due to a herniated disk but the effect remains controversial. L-lysine aescinate showed superiority over placebo or baseline therapy with NSAIDs alone in treating sciatica, but have not been evaluated in an appropriately powered clinical trial. Materials and Methods. Randomized, double-blind clinical trial conducted in two health centers in collaboration with Uzhhorod Natioanl University in Ukraine. Adults (N = 90) with acute radicular pain and a herniated disk confirmed by MRI were eligible. Participants were randomly assigned to three groups (N = 30 in each) to receive a baseline therapy with lornoxicam (16 mg per day) and adjunctive 5-day course of IV dexamethasone (first group: 8 mg per day/40 mg total) or 0,1% solution of L-lysine aescinate (5 mL and 10 mL for group 2 and 3 respectively). Primary outcomes were Visual Analogue Scale changes and the straight leg raise angle at 15th and 30th day. Results. The level of pain improvement at 15th days after initiation of therapy with dexamethasone or solution of L-lysine aescinate at doses of 5 or 10 mL was not significantly different. The lowest levels of pain were achieved in patients who received the L-lysine aescinate 10 mL, but the range of decrease in pain was slightly greater in the group administered dexamethasone. Conclusions. Among patients with acute radiculopathy due to a herniated lumbar disk a short course of IV dexamethasone or L-lysine aescinate resulted in pain improvement at 15th and 30th day. Dexamethasone may be preferable if a longer-term analgesic effect is needed. Taking into account side effects of dexamethasone, a solution of L-lysine aescinate can be used to relieve pain symptoms.
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spelling pubmed-69156812019-12-24 Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk Oros, Mykhaylo Oros Jar, Mykhailo Grabar, Vasyl Medicina (Kaunas) Article Background and objectives. The efficacy of commonly prescribed analgesic and adjuvant drugs for the management of patients with radiculopathy has not been well established. Oral steroids are commonly used to treat sciatica or radiculopathy due to a herniated disk but the effect remains controversial. L-lysine aescinate showed superiority over placebo or baseline therapy with NSAIDs alone in treating sciatica, but have not been evaluated in an appropriately powered clinical trial. Materials and Methods. Randomized, double-blind clinical trial conducted in two health centers in collaboration with Uzhhorod Natioanl University in Ukraine. Adults (N = 90) with acute radicular pain and a herniated disk confirmed by MRI were eligible. Participants were randomly assigned to three groups (N = 30 in each) to receive a baseline therapy with lornoxicam (16 mg per day) and adjunctive 5-day course of IV dexamethasone (first group: 8 mg per day/40 mg total) or 0,1% solution of L-lysine aescinate (5 mL and 10 mL for group 2 and 3 respectively). Primary outcomes were Visual Analogue Scale changes and the straight leg raise angle at 15th and 30th day. Results. The level of pain improvement at 15th days after initiation of therapy with dexamethasone or solution of L-lysine aescinate at doses of 5 or 10 mL was not significantly different. The lowest levels of pain were achieved in patients who received the L-lysine aescinate 10 mL, but the range of decrease in pain was slightly greater in the group administered dexamethasone. Conclusions. Among patients with acute radiculopathy due to a herniated lumbar disk a short course of IV dexamethasone or L-lysine aescinate resulted in pain improvement at 15th and 30th day. Dexamethasone may be preferable if a longer-term analgesic effect is needed. Taking into account side effects of dexamethasone, a solution of L-lysine aescinate can be used to relieve pain symptoms. MDPI 2019-11-14 /pmc/articles/PMC6915681/ /pubmed/31739434 http://dx.doi.org/10.3390/medicina55110736 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oros, Mykhaylo
Oros Jar, Mykhailo
Grabar, Vasyl
Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk
title Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk
title_full Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk
title_fullStr Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk
title_full_unstemmed Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk
title_short Steroids and L-Lysine Aescinate for Acute Radiculopathy Due to a Herniated Lumbar Disk
title_sort steroids and l-lysine aescinate for acute radiculopathy due to a herniated lumbar disk
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915681/
https://www.ncbi.nlm.nih.gov/pubmed/31739434
http://dx.doi.org/10.3390/medicina55110736
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